anthropology

CAARTICULATING POTENTIALITY: Notes on theDelineation of the Blank Figure in Human EmbryonicStem Cell ResearchMETTE N. SVENDSENUniversity of Copenhagen

An experienced female clinician,who often asked couples in fertility treatmentabout embryo donation to human embryonic stem cell (hESC) research, told me:It isnt difficult to ask couples to donate embryos that would be thrown outanyway. . . .Of course it may be difficult for the couple to live with the thoughtthat some of their cells which didnt turn into a child circulate in cell lines thatmay be used therapeutically at some stage . . . but I dont think its problematicto ask them. These images of waste, circulation, and not a childalthough witha trace of relatednessare at the heart of my exploration of how the embryo inhESC research was presented to in vitro fertilization (IVF) couples in Denmark ashaving a particular potential and how IVF couples reflected upon and experiencedpotentiality in embryos in hESC research. The ability of embryonic stem cells to giverise to every tissue type of an organism has made embryos a promising rawmaterialin the hoped-for era of regenerative medicine. In most cases, these embryos comefrom IVF treatment, where they are deemed surplus or spare and are donatedby couples undergoing IVF. In Denmark, as in a number of European countries, thedesired future of regenerative medicine has given way to the legal use of embryos inhESC research. In most cases, what sparenessmeans is not covered by legislation andmay refer both to excess (more than can be used) and to waste (other than can beused). In this article, I focus on disposal as a framework for defining fresh embryos aspotential in hESC research in Denmark and discuss the figures of waste and blanknessin envisioning boundless potential through the circulation of bodily matter.

CULTURAL ANTHROPOLOGY, Vol. 26, Issue 3, pp. 414437. ISSN 0886-7356, online ISSN 1548-1360. C 2011 bythe American Anthropological Association. All rights reserved. DOI: 10.1111/j.1548-1360.2011.01105.x

ARTICUTATING POTENTIALITY

As part of a three-year study of the processes through which hESC researchwas made possible in Denmark, I began research in a fertility clinic at a universityhospital in Copenhagen in 2004. For five months I followed embryo donationfrom the fertility laboratory (where embryos for donation were selected) to theclinical setting (where IVF couples were asked to donate) and on to the lives of IVFcouples (how they experienced the question of donation). My fieldwork comprisedobservations of the selection of embryos in the fertility laboratory, observationsof clinical conversations where the issue of embryo donation to hESC researchwas presented to IVF couples, participation in staff meetings, interviews withclinicians and stem cell researchers, conversations with IVF couples in the clinic,and interviews with eight IVF couples who donated embryos to hESC research.The interviews with donor couples were in the couples homes one or two weeksafter the donation.

In the clinic, embryos that were not viable and were to be thrown out were re-ferred to as bin embryos (skraldespandsg), as they would end up in the laboratorybin with broken glass and biological waste. Among staff, the issue of asking IVF cou-ples to donate bin embryos was considered unproblematic.What was to be donatedwaswaste and therefore not something of useable value for the couple. Inmost casesI followed, IVF couples donated bin embryos without much consideration. Like thestaff, they did not question the donation of such embryos to hESC research. Duringmy fieldwork, I found both staff and IVF couples to be frank and straightforwardabout the issue: why be bothered about the ethics of donating embryos that weredefined as waste and belonged in the bin? In this article, I wish to focus precisely onthis issue: the coming into being of the bin embryo as a field of potentiality and thecultural meanings and moral horizons at stake in defining its potentiality. As such,I am interested in the constitution of waste, how it is revalued (Thompson 1979;Waldby and Mitchell 2006), and how separating the embryo from specific socialand moral contexts and relations made this happen (Morgan 2002). In analyzing thearticulations of the bin embryo as a field of potentiality, I argue that the negotiationbetween the embryo as a biographical life (becoming an individual) and the embryoas a biological resource (becoming a cell line) took place in the clinic and in the livesof the IVF couples. Nevertheless, the particular way in which the potentiality of theembryo appeared made this negotiation somewhat invisible and contributed to theeasewithwhich IVF couplesweremobilized as donors of embryos to hESC research.

In asking questions about how the potentiality of embryos in hESC researchis presented to IVF couples by clinicians and experienced by IVF couples, I aminterested in the act of articulating embryos as potential and the effects of such

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an act. When studying the many expectations and hopes articulated in relationto life science research, scholars within the emergent field of the sociology ofexpectations have pointed to expectations as imagined geographies within whichthe creation of knowledge, the enrollment of different groups of actors withinthe innovation process, and the development of clinical applications cannot beseparated (Brown 2003; Martin et al. 2008). These scholars have emphasized thatarticulations of expectations are not simply to be approached as a question ofhope or hype; instead, they should be analyzed as action that is constitutive of andconstituted by the development of science and financial investments and also bythe enrollment of different groups of patients and citizens in scientific projects.

Using this approach, I view articulations of potentiality as acts deeply em-bedded in a social context and constitutive of the mobilization of social relationsand networks. In exploring how articulations of potentials mobilize IVF couplesas donors of fresh embryos to hESC research, I want to bring the insights fromthe sociology of expectations into dialogue with anthropology. In particular, I aminterested in the notions of potentiality at stake in clinicians talk about embryosas a potential resource in hESC research, the understandings of relatedness con-veyed in IVF couples reflections on the potentiality of embryos in hESC research,and the moral judgments of particular futures and relationships being expressedthrough articulations of potentiality. Although expectations and potentiality mayboth seem to signify incompleteness as well as transformation, I suggest that ananthropological approach to potentiality,more than an approach from the sociologyof expectations, addresses the cultural context as well as the material conditions ofthat seen as incomplete yet with a powera potencyto develop into somethingelse. In the following, I seek to draw attention to the cultural meanings and moralhorizons actualized in talk about potential and the ways in which articulations ofpotentiality interact with, rather than follow, the material processes of cells. I pointout that the blank figure plays a central part in articulations of potentiality, therebyfacilitating hope and futurity.

I begin with a short outline of how social scientists have described embryosin the context of IVF and hESC research and introduce the Danish case. Then Ianalyze the clinical conversations in which I discuss the notions of potentiality atstake in the way Danish clinicians introduce the use of embryos in hESC research toIVF couples. I then explore the ways IVF couples express their relationship to thepotentiality of the embryo in hESC research, emphasizing their efforts to detachthemselves from the donated embryo. In the final, empirical section, I analyzethe ambiguitieswhat I describe as trace effectsin the couples narratives and

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elucidate the understandings of relatedness at stake in imagining the potentialityof the embryo. I end with a discussion of how objects come to appear as potentialthrough interactions between articulations and material processes.

POTENTIALITY TRAILS

Anthropological and sociological studies of reproductive medicine identifythe embryo as culturally and politically constructed and are insightful regardingthe specificities through which this happens in different social settings (Franklinand Roberts 2006; Kahn 2000; Morgan 2009; Roberts 2007; Thompson 2005).In examining how embryos are conceptualized among staff within IVF and preim-plantation genetic diagnosis in British clinics, Kathryn Ehrich and her colleaguesdistinguish between three views that attach different (and increasing) moral sta-tus to the embryo: a bunch of cells, cells with a special potential, and alife/beings/babies (Ehrich et al. 2008). These views capture, I suggest, the inter-action between what Charis Thompson in her ethnography of IVF in the UnitedStates describes as the sacred and the profane. Thompson argues that in beingroutinely manipulated and stored, embryos are treated as profane objects, but inbeing seen as holding intrinsic and inviolable worth, they are treated as sacred(Thompson 2005:259). Within the context of IVF, these sacred and profane ob-jects may enter different paths; that is, they may be transferred, frozen, donatedto research, or discarded (Thompson 2005:251). Although the pregnancy trail(transfer or freezer) is the default and desired trajectory of embryos producedin IVF (Cussins 1998), hESC research has made the research trail (Parry 2006)increasingly visible, illustrating the destiny of embryos as either biographical lives(becoming an individual) or biological lives (transformed into cell lines and con-tinuing life in the laboratory; see Svendsen and Koch 2008; Waldby 2002:313).In European and North American settings, the biographical embryo implies anindividual biography in the sense of a child connected to a set of parents. Re-cently, anthropological studies of IVF outside Europe and North America havepointed to the specificity of this configuration (Kahn 2000; Roberts 2007). Inher ethnography on IVF in Ecuador, Elisabeth Roberts notes that for Ecuadorianscryopreserved embryos are conceptualized as family members and that uncon-trolled circulation, more than their death, causes anxiety (Roberts 2007:183). Incontrast to the life ethics of North Americans, in which the embryo is framedforemost as a life stripped of social relations, Ecuadorians seem to be engaged in kinethics, providing the cryopreserved embryo with a familial biography. In Egypt,third-party donation (e.g., sperm donation) is morally unacceptable to Egyptians,

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as it resembles adultery and disrupts patrilineal continuity, thereby confusing linesof descent (Inhorn 2003:85121). These different ethnographies draw attentionto the possible collectives that might be at stake when assessing the potentiality ofembryos and constituting them as biologies or biographies.

The scholarly conceptualizations of embryosas sacred and profane, as bio-graphical and biological, and as entities with different trailstake the potentialityof embryos as their point of departure and capture the different ways in whichtheir life-creating potential (Thompson 2005:255) is perceived, negotiated, andacted on (Ehrich et al. 2008; Franklin 2006; Svendsen and Koch 2008; Thompson2005). Here, I start one step earlier and explore the practices of articulation takingplace in the clinic that single out an embryo as potential and the collectives at stakein placing the embryo on a particular trail.

THE POLITICS OF REPRODUCTION IN DENMARK

Denmark has a long history of state involvement in reproductive matters(Andersen 2005; Koch 1996). In the 1930s, eugenic legislation became part of thesocial democratic welfare politics. In the 1940s, state-financed prenatal care wasintroduced with the state-financed institution of visiting nurses entering the homesof newmothers and their babies. Abortion and IVF treatment became state-financedservices in the 1970s and 1980s, respectively. In the late 1970s, prenatal diagnosiswas introduced and argued for in health-economic terms as a means to preventdisabled children from being born. In 2004, this argument was explicitly rejected,and today prenatal diagnosis is framed in the neoliberal language of personalchoice.

Throughout the 20th century, the various remains (embryos, aborted fetuses,placentas) were considered something to be disposed of in the domain of welfarestate institutions (Hoeyer et al. 2009), and in general there has been great publictrust in and familiarity with these institutions. Also throughout the 20th century,research on reproductive matters was state funded, and in 2003 Denmark legalizedthe use of embryos in hESC research. This legalization concerned only embryoscategorized as spare in IVF treatment. Prior to the passing of the act legalizinghESC research, a parliamentary process took place. In the beginning of this process,the two moral framings of the spare embryo as respectively a biographical life asan end in itself and a biological life as a means to stem cell therapy were stronglyrepresented in both newspaper articles and public hearings on the issue. However,in the latter part of the parliamentary process andmedia coverage, the view in favorof hESC research appeared as a relation between industrial and public stem cell

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research (portrayed as holding the key to future cures) and patients suffering fromserious diseases (portrayed as having legitimate expectations of future cures; seeHorst 2008:201202). Thus, during the policy process, a powerful relationshipemerged among patients needing therapy; committed scientists; the industry,favoring national economic growth; and the spare embryo as a group of cells. Incontrast, in the latter part of the policy process, the view against the use of embryosin hESC research was not so much articulated as a universal ethical principle but asan argument represented by the somewhat weak alliance of the small political partyof the Christian Democrats and a minority in the Danish Council of Ethics, both ofwhom argued for the fetus and its right to life (Horst 2008:201202). After thepassing of the act legalizing hESC research, fertility clinics in collaboration withstem cell laboratories developed procedures for embryo donation that would allowa redirection of embryos from the pregnancy trail to the research trail.

The state-financed health services in Denmark subsidize three cycles of IVFfor infertile women aged between 18 and 40 years, regardless of marital statusand up to the birth of two live children.1 Although private fertility clinics mayserve women aged more than 40 years and those who may already have two livechildren, the fertility act has recently been revised to require that both publicand private clinics assess what is referred to as every womans ability to parent(Danish Parliament 2006). This requirement was introduced to avoid the situationof children born through fertility treatment being taken into care, legislation thatillustrates as the responsibility of the state the health and happiness of the familyand the costs related to dysfunctional family life (Koch 2009:4950).

The IVF clinic where I did my fieldwork is the largest in Denmark, lo-cated at the main university hospital in Copenhagen and financed by the state.Patients come from all levels of society, with middle-class patients making upthe biggest group. The clinic has the explicit ideal of reducing the number ofembryos transferred in a cycle to minimize multiple pregnancies associated withrisk of pregnancy complications, birth defects, and consequently, increased healthcosts.

What is most prominent in the aforementioned studies of embryos in IVF,preimplantation genetic diagnosis, and hESC is theway articulations of potentialitiesare closely linked to practices of selecting and ranking embryos. In theDanish clinic,ranking and selecting embryos made up the first step of putting embryos on theresearch trail. Everymorning, laboratory assistants assessed the viability of embryosand selected those to be transferred. This assessment of embryos was based on themorphology of the embryo as revealed through the microscope and talked about

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as a question of the embryos look. Thus, embryos that had divided regularlywere referred to as beautiful (smukke) or nice (pne) and were deemed embryoswith a high fertility potential to be transferred or put in the freezer for future use(pregnancy trail). This connection between the embryo on the pregnancy trail and abiographical life was also expressed in many other ways. Early on in my fieldwork,a laboratory assistant opened the liquid nitrogen tank with frozen embryos andexplained, Here we keep all our children. On the contrary, embryos that lookedfragmented and indicated chromosome disorders were classified as not viable interms of pregnancy and referred to as ugly (grimme), not nice (ikke pne), oras bin embryos (skraldespandsg) and were increasingly talked about as spare(overskydende) objects of donation (research trail).

Decisions about which embryos had the potentiality of a biography werenot based on ideologies of race or class, as has occurred elsewhere (Kahn 2000;Roberts 2007). Rather, the ability to parent legislation, the clinics practice ofselection, and its policy of reducing multiple births highlight a strong notion ofhealth in terms of individual, family, and nation. As such, these practices illustratea continuation of the eugenics policies of the 1930s, holding as an ideal the healthycitizen contributing to the collective of the nation. A major difference is that whiledecisions about the potentiality of biographical lives in the 1930s made explicitreference to the idea of a healthy collective, such decisions as played out in IVFare now argued with reference to the unquestionable value of a healthy and happyindividual. Nevertheless, the understanding that this healthy and happy individualbelongs to a collective, comprising both state institutions and fellow citizens, ispresent in both legislation and clinical practices.

In the clinical practices of selecting embryos, the interaction between artic-ulations of potentiality and the materiality of the embryo shaped what was doneto embryos and which embryos reached the second step of the donation pro-cedure: the clinical conversations in which IVF couples were introduced to thepossibility of donating specific embryos (all fresh) to hESC research. This intro-duction took place immediately after the embryo transfer in a conversation thatcentered on the couples stock of embryos. The third step was initiated at theend of the conversation, when information sheets and an informed consent formwere given to the couple, who had to read through the text and give or refuse togive consent before leaving the clinic.2 Consent implied that the embryo was incustody in the hESC laboratory, a public health institution located at the universityhospital.

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MAKING THE BLANK PRESENT

Frommyplace in the laboratory next to the roomof the transfer, I followed theclinicians movements and their talk with a patient while transferring an embryo toherwomb.On the completion of the transfer, I stepped into the room and observedthe conversation between the clinician (a medical doctor) and the couple. Thisconversation was focused on the couples stock of embryos for cryopreservation.If the couple had fresh embryos considered spare, the clinician introduced theissue of donation:

There are two embryos left that we cant use. They have several nuclei, whichindicates theres something wrong with the chromosomes. Normally, wethrow out such embryos, but wed like to ask you if we may dispose of themin a specific way . . . that is, if you would donate these embryos to research,to stem cell research.

On the wall hung a poster depicting embryos of different quality; the clinicianwould contrast the look of an embryo selected for transfer with one that could beselected for donation. In some cases, the clinician would also explicitly contraststem cell research with cloning techniques: This [embryonic stem cell research]has nothing to do with cloning. No child will come out of this.

Having introduced the issue of donation, the clinician would go on to say afew words about stem cell research:

In the lab, theyll continue to make it grow [make it differentiate into ablastocyst] and take out the cells that have a potential to become a fetus tosee if these embryonic cells develop into other kinds of cells, such as insulin-producing beta cells, providing treatment for diabetes. The idea is to build uplarge reserves of cells.

In another situation, a clinician might stress that the embryonic cells can be-come anything. In all conversations I overheard, cures for Alzheimers disease,Parkinsons disease, and diabetes were enthusiastically stated as the target of stemcell research, while at the same time the clinicians emphasized, Its far from beingrealized and may take another five, ten years of research. At the moment the aimis to establish cell lines.

In his outline of a theory of rubbish, anthropologist Michael Thompson identi-fies the transient and the durable as two overt categories with which British peopleclassify objects. He argues that placing an object in a third covert category, thatof rubbish, may transfer it from the transient category to the durable category,

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thereby reevaluating a waste object (Thompson 1979:89, 4445). So how areembryos classified as rubbish in the clinical conversations, and how does the cate-gory of rubbish facilitate their reevaluation? In their outline of tissue economies,Catherine Waldby and Robert Mitchell note that the separation of fragment fromwhole is a precondition for the existence of waste. When tissue is designated aswaste, it has been actively detached and cast off from its source. In that sense, wastetissue is defined in terms of a specific relationship between person and fragment(Waldby and Mitchell 2006:114115). By focusing on the goal of treatment andpointing out the ugly look of the embryo, the clinical conversations in the fertilityclinic made the ugly embryos appear as embryos we cannot use, as fragmentaryand transient objects detached from the totality of the couple and their pregnancytrail. The IVF couples attention was turned toward the bin and toward donationframed as a means of accounting for waste. However, what had just been made intoprofane rubbish and placed in the bin then emerged as sacred: embryonic cellscan become anything. Potentiality was reframed by offering the rejected fragmenta relationship to a new totality: lifesaving therapies. This reissuing of potentialityneither nullified the embryo as a profane tool nor as a sacred value. Rather, the binfacilitated a rearrangement of meaning. The embryo for donation appeared as botha profane tool to be manipulated in the hESC lab and as a sacred potential holdinginviolable worth for regenerative medicine.

What I found most striking about this way of recalibrating the embryo wasthe way in which the clinicians talk about how the embryonic cells can becomeanything explicitly communicated that there was something they could not be-come. Separating the embryo from the context of becoming human biographicallife, which was reiterated in the explicit distinction between hESC research andcloning, became the first step of defining embryos as undetermined potentiality.Talked about as something that can become anything, the embryo for donationappeared as what Michel Serres refers to as the blank figure (Serres 1991), intro-duced in his discussion of how new forms of order emerge. Through an explorationof Livys classical account of the history of ancient Rome, Serres describes theconcept of blankness as a state in which all possibilities exist. The blank figure isthe essentially undefined and undetermined element that may take on any value oridentity but, as yet, has no specific determination (Serres 1991:93). As a mobilewhite space which can be deployed in any position (Brown 2002:20), the blankis a wildcard. By specifically pointing not to the embryo but to the embryoniccells, clinicians introduced these cells as clusters of irregular, boundless cells, andthis boundlessness established the embryos as an undetermined element, a mobile

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white space in which all possibilities exist. Although the clinicians mentioned thecurrent difficulties with establishing stem cell lines and making them develop, theconversations revolved around expectations of future cures. Blankness facilitatedprojections (Langstrup and Sommerlund 2009), which meant that the bin embryo,although not yet anything, had an ability to become everything in the future; whatLena Eriksson and Andrew Webster in their study of standardization processes inhESC research describe as not-yet-ness (Eriksson and Webster 2008:62). Thereference to future cures meant that the dominant notion of potentiality actualizedin establishing the embryo as blank was one of radical transformation, of jumpingfrom being one thing (bin embryo) to becoming another (therapy). Freed fromthe moral constrains of a biographical human life, embryonic cells appeared asa therapeutic promise (Rubin 2008). In moving the embryo to the bin, it wasemptied of a biographical life and articulated as boundless biological potential. Ithad the ability to take on new identity, temporality, and value.

MAKING THE BLANK ABSENT

By spelling out the socially constituted boundary between nonrubbish andrubbish, Thompsons theory of waste also draws attention to disposal as an actof placing and not simply as an erasure of an object. Conceived as such, what isdisposed of does not necessarily disappear for good but may return, and in thissense disposal involves issues of movement, transformation, incompleteness, andreturn (Hetherington 2004).3 From this perspective, we can view the donationprocedure as making the embryo absent for fertility treatment by designating it aswaste, then asking the couples to dispose of waste in hESC research, and at lastensuring the couples that waste will not be able to return as something connectedto them (the embryonic cells had no possibility of turning into individuals whocould hunt out their parents, and future users of cells would not be able to look updonors because all information about donors would be confidential). In the clinicalconversations, accounting for ugly embryos through donation appeared as a meansof placing waste in what, from the position of IVF treatment, were absent actions(e.g., lab work and clinical trials) and of trusting those actions.

The donation of bin embryos introduced the IVF couples to a different way ofvaluing, and thus relating, them. Disposed in hESC research, the embryos gainedvalue through flowing, that is, moving from one space (fertility clinics) to anotherspace (stem cell research labs) and from there to other spaces such as the bodiesof future citizens in need of cells. In this way the orientation toward the binand from the bin to hESC labs and future patients made possible a new way of

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seeing and finding ones way in an emerging bioeconomy, that is, seeing bodilysubstances as blanks circulating outside the body and developing into treatment.The potentiality of the ugly embryo did not so much appear as intrinsic as realizedover time and in relations between different actors and different spaces. In allclinical conversations, the named spaces to which the embryo would move (e.g.,the laboratory, future clinical practices) were understood as located within publichealth, thereby reflecting the Danish tradition of letting welfare state institutionstake care of reproductive matters and life material designated as waste. Thus,donation was framed as an act of waste disposal in the spaces of the welfarestate and making them turn into therapeutic potential for the collective of futurecitizens.

Most couples depicted the donated embryo as a product that to them hadzero value and zero expected life-span (Thompson 1979:9). Within this frame-work, where the embryo had no pregnancy value and was not an individual, whatappeared was the positive experience of having saved the embryo from the binand having provided it with a future in which it contributed to human health.One man described the embryo for donation as precious, and his wife remarked,It has cost us a lot financially, emotionally, and psychologically . . . bodily. Shealso said: Rather than staying in the bin, they [the donated embryos] will proveuseful. Theyve already developed, and you cant take that back. By under-standing embryo donation as a way of rehabilitating waste and making a usevalue of what had already progressed yet was incomplete, donation appeared atonce effortless and comforting. In interactions between clinicians and IVF cou-ples, the words ugly and bin had already transformed the embryo in questioninto a donated embryo, even before the couples had read the information sheetsand reflected on the possibility of not signing. Donation became an effect ofpredisposal.

The act of donation also meant that the couples related to donated embryosin a new way. This was evident in the distinctions they made between the embryosthey had donated and those transferred to womens wombs. In general, womenhad intimate relationships to the embryos in their womb and did what they couldto create the best environment for the embryo to develop. Placed in the womb,the embryo had become an insider (Ehrich et al. 2007) and was a living entity thatliked some things better than others and had needs to keep dividing and progressing.Pregnant women made many efforts, among them not drinking coffee, getting alot of rest, and avoiding physical work, to facilitate the development of this insider.Care of this kind was not present for the donated embryos. One woman said: I am

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not responsible for it. It is not a child which I have to take care of. It is somethingthat science decided to go on with. Another woman described it as such: I dontthink of the donated embryo any longer. If I had to, I wouldnt have energy foranything else . . . because then I would think of what it goes through and whereit is going and who will need it tomorrow. I think that when you donate it, youhave to give it up. Although it in the first part of the quote refers to the uglyembryo that cannot be used, the very last it (you have to give it up) seems tocapture more than the itness of the material embryo. At stake in this it is alsothe expectation of a biographical life related to her. Repotentializing the embryothus implied resetting the expectation of making parents (Thompson 2005) andconsequently giving up hoped-for relationships, indicating the presence of both lifeethics and kin ethics in the couples perceptions of donated embryos. Based oninterviews with donors in Britain and Switzerland, Erica Haimes and colleaguesdescribe embryo donation to hESC research as implying a shift in perspectivefrom our embryo to an embryo, from the specific embryo produced throughIVF and imbued with social and moral values to any particular embryo resultingfrom the IVF process (Haimes et al. 2008). In the Danish case, this shift seemedto imply a change in the embryos identity and relationships. As a biographicalpotential, the embryo appeared as a future individual and belonged to a collectiveof kin; as a biological potential, the embryo had been depersonalized and was thegood of an unspecified societal collective that could exchange and transform it inunpredictable ways. This collective, as described in conversations about donation,included both fellow citizens and state institutions. One donor understood herdonation as a contribution to the children of society. For a number of IVFcouples, this contribution took the form of both a profane material substanceand a sacred life potential for future citizens. The embryo was experienced ascirculating among themselves, researchers, public health institutions, and futurecitizens, who, through the exchange, belonged together and made up society. Inmy conversations with donors, the sociality of this society was characterized byanonymous relationships and generalized exchanges (see Svendsen 2007:3638).Thus, Danish understandings of biological and biographical potential contained notonly a distinction between thing and person but also a distinction between twodifferent collectives and ways of standing in relationships. Therefore, to move theembryo to the anonymous collective of society, kin relationships and kin ethics hadto be forfeited.4

This distinction between two collectives also came through in the way mostIVF couples disliked the thought of knowing the identity of future users, were

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such information to be available. The rationale seemed to be that if one hadinformation, contact could be made and a relationship between the parties maythen take shape. Reflecting on what it would be like to be on the receiving end,one man said: This would be an odd situation. It wouldnt be very nice for thisperson to be thankful to us. Should he then send us flowers every Christmas? Youcant do that. The gift of embryonic cells would create a personal return gift(flowers) and a possible continuing relationship (every Christmas). In imagining acontinued relationship, this man may have hinted at understanding the exchange ofembryonic cells between donors and receivers as creating a biological connection.Given that for Euro-Americans biology is rooted in an order of reality to whichsocial arrangements must attend (Strathern 1992b:26), a biological tie wouldcreate an incentive for a social contact, and thus information about biological tiescomes with certain built-in effects (Strathern 1999). I suggest that by explicitlystating their dislike of having information about embryo recipients, the IVF couplessought to limit possible built-in affects. In the Danish case, the wish to limit suchaffects concerned donors efforts to make the donated embryo stay within theunspecified collective of society without returning to the collective of kin. Thus,while the signed consent form worked as a contract that emotionally, socially,and legally transferred custody of the embryonic cells from the couple to thehESC lab and secured anonymity, such boundaries between donors and embryosand between donors and possible recipients were continuously restated in thecouples narratives. Detachment was never complete and had to be continuouslyreestablished. This echoes Naomi Pfeffers finding that British women tend to viewan aborted fetus as waste, yet because of its possible biography it is not alwaysjust that (Pfeffer 2008:2550). In articulating boundaries, the Danish IVF couplesnarratives both reiterated the blankness of the donated embryo by emphasizingthat what was donated was not a biographical life related to a collective of kinand attempted to make the donated embryo a safe blank detached from its origin.Boundaries made possible the mobilization and circulation of the blank in such away that it would not trouble its reproductive past (Franklin 2006) of makingparents (Thompson 2005).

Notably, the boundaries established in the organizational setup of donationand in the narratives of the couples did the work required to keep embryos movingalong to the laboratory. The boundaries contributed to the couples experience ofsuccessful gatekeeping, of absence as well managed. In general, the couples didnot imagine scenarios of donated embryos as attaining shocking new presences,such as clones reappearing in their lives. They trusted that welfare state institutions

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would take proper care of not-yet-ness and did not expect the absent to return as ahaunting ghost (Hetherington 2004:170) claiming a relationship of kin. Althoughthis trust may express a great familiarity with state involvement in reproductivematters as well as a close relationship between couples and clinic, it does notmean that the couples imagined their donated embryos as gone forever or withoutconnections to their origin.

TRACE EFFECTS

In his exploration of the disposal of meaning, Roland Munro, drawing onthe work of Jacques Derrida (1982), argues that when we dispose by making adifference and a deferral, an excess in meaning is created that may be disregardedbut cannot be abandoned (Munro 2001:118121). In other words, the detachmentof fragment from totality implied in the act of disposing sets up a trace of theconnection once present but now made absent. Emmanuel Levinas suggests thatthe trace is the absent space of the past being let into the present (Levinas 1993:70),thereby actualizing through memory the past in the present.

Trace effects were present in my fieldwork, and most had to do with theprecisely drawn boundaries between embryo and individual and between embryoand the self of the donor. One husband referred to the donated embryo as ourlittle biochemical thing. Although spoken of as a profane tool in the lab, in beingnamed our little, the embryo maintained the traces of a child related to the selvesof its parents.

In particular, one conversation with an IVF couple revealed trace effects thatgave way to a strong ambiguity about donation. I met this couple, who weremarried, in the clinic, and the following conversation took place as they readthrough the information sheets discussing the issue of donation. The wife was readyto consent to donation, but the husband had his doubts:

HUSBAND: Its this thing that it may stay alive. It may overtake me and turn intoa lung while my wife is still waiting to become pregnant and we dont havea child yet. I think it would be different if we were to donate it to anothercouple who were to use it for a specific thing. But this is so uncertain. Nobodyknows whats going to happen to it.WIFE: But research is like that.HUSBAND [addressing both me and his wife]: It isnt the case that I find itswrong and dangerous to do this [hESC research]. And to make the decision[about donation] is part of life today. I am just trying to find out why Imnot completely sure. I think it would be different if it were something dead

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that they took to pieces and did something to, but this is alive and it can stayalive. . . . I know that research has come so far because other patients haveagreed to participate, and I appreciate that.WIFE: We have also been helped here.HUSBAND: Someone may make money out of this. It may end up in business.Id feel much better if they just used it four to six months and no more. Itsthis about actually growing it, growing something of mine and for many years,and it can stay alive.

On the consent form the couples could consent to no donation, donation toresearch, and donation to research and therapy. Donation to research impliedthat the reengineered materiality of the embryo would not be able to travel tofuture bodies, whereas consenting to donation to research and therapy wouldallow for embryonic cells to end up as hESC therapy in future clinical practice.After some discussion, the couple chose donation to research. Within the groupof donors I talked to, this was the only couple to not consent to both research andtherapy.

The conversation between the three of us rendered visible the difficulties ingiving it up. Both husband and wife identified with the view of the bin embryoas something that could circulate as part of a direct exchange with the clinic(we have also been helped here) embedded in a generalized exchange with asocietal collective (I know that research has come so far because other patientshave agreed to participate). It was therefore not the moral status of the embryoas a sacred biographical life that made the husband hesitate; rather, what wasbrought out in his reflections on not being completely sure was the circumstancethat the embryo was alive (it may stay alive) and related to him (somethingof mine). Although he did not name it as a person, the dominant notion of theembryo as a biographical life placed in a collective of kin created a sticky traceand made him account for the bin embryo by letting it move to the laboratoryonly.

In her investigations of how British women think about donating an abortedfetus to stem cell research, Pfeffer (2008) describes attitudes and reflections similarto those of the husband. She conceptualizes her interviewees hypothesized con-nections to a donated fetus as a duty of care for the fetuss physical existence andsocial biography beyond abortion (Pfeffer 2008:2553). I suggest that kinship think-ing may further our understanding of how this duty of care has been embeddedin traces of being related in time and in social relations. In Euro-American kinship

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thinking, life flows down from parents to children, and the temporal sequencing ofgenerations is considered irreversible (Strathern 1992a:62). From this perspective,the embryo (as a new life) should be after and should not overtake its fatherby developing into an organ while the father remained in fertility treatment. Thus,insisting on the embryo as related to its origin (something of mine), the possiblereversibility of generations (in the sense of an embryo progressing while its parentwas caught in the cyclic time of fertility treatment) was troubling. In his discussionof disposal, Munro states, an attempted erasure of a trace simply creates anothertrace (Munro 2001:121). In the present case, the attempt to delete the image ofa child simply created the image of a lung placed in time and in social relationselsewhere. The husbands reflections somehow delineated ways of being relatedto and thinking about embryos that take us beyond the trails of pregnancy andresearch as well as of biographical lives and biological lives. The husband did notimagine his hoped-for child as turned into a lung but as a lung related to him. Thetrace of the pregnancy trail in deliberations on donation created a new potentialitytrail of a lung in time and in relationships, a trail that blurred the boundaries of thetwo former trails and made it difficult to give it up.

In the present case, the scenario of a future lung being sold off-the-shelf stoodin an uncertain relationship to the embryos past form, that is, to its embeddednessin the process of making parents (Thompson 2005) through IVF. When taking theform of an (embryo-to-become) individual, the embryo could become part of aparticular collective of kin if donated to another family. When taking the form ofan (embryonic-cells-to-become) lung, it would belong to the unspecified collectiveof society, which may allow it to enter a commercial domain. The husbandsnegotiation of the not-yet-ness of the embryo revolved around traces of relatednesswhen imagining body parts in commercial exchange. His hesitation did not expressan unwillingness to contribute to the collective of society. Rather, he felt uneasyabout mixing different forms of relatedness, the personal relatedness imaginedthrough a biological tie and the impersonal relatedness connecting members of thesocietal collective.

In Europe, it is a common view that bodily substances should be kept separatefrom monetary transactions (see, e.g., Felt et al. 2009; Hoeyer 2005; Svendsen2007), yet what comes to the fore in the present case is a notion of the commercialexchanges as being without limits.5 The husband was not contesting the use ofembryos in stem cell research in general, but he disliked the way in which thecommercial domain did not set time limits on potentiality (growing something ofmine and for many years) and to its future form (This is so uncertain. Nobody

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knows whats going to happen to it). Time limits (four to six months) became away to delineate a blank with boundaries on its future itinerary and possible forms.By choosing donation for research instead of donation for research and therapyon the consent sheet, he reconciled the moral tension between the embryos pastform (biography related to him) and its possible future form and affiliations (biologyto be exchanged). Having established this safe blank, the couple experienceddonation as a right and self-evident act.

The case reveals how the ability to become anything creates both hopesand fears. The fluidity of the biological was not experienced only as a positivetherapeutic promise (Rubin 2008) but was also feared as an unwanted potential.In my conversations with other couples, tensions between the donated embryospast and possible futures were also present, indicating that although this particularcouple was unusual in its hesitation about donation, the considerations of both thehusband and wife reflected concerns common to all donors. In calling a donatedembryo our little chemical thing, as one couple did, and in emphasizing thecirculation of embryonic cells as taking place within public health care only (apartfrom the market), most couples expressed the view that the future form of theirembryonic cells and their possible affiliations mattered to them. In referring to theembryo as a tool in the lab that would help the children of society, the care wasnot simply for the material embryo. The institutional settings that acted with itand the future users of regenerative medicine were somehow also part of what wascared for, indicating that in no respect did donors create an opposition betweenthemselves and the collective of society. The Danish IVF couples simultaneouslyexpressed their trust in and familiarity with state involvement in reproductivematters and worked to sort out the possible tension between the different modes ofacting in and understanding relationships that appeared when placing the embryoon the research trail. In relating to the articulated blankness of embryos on theresearch trail, traces of the embryos origins were continuously present, expressed,negotiated, and reworked.

CONCLUDING REMARKS

The articulations throughwhich theugly embryo came to appear as a fieldof po-tentiality in hESC research point to the bin as an important conceptual framework.Defined as waste, the embryos slotted for donation to hESC research appearedas blanks with a capacity to unfold indefinitely and in many different directions.That is, stating the nonpotentiality of the embryo to become an individual becamethe very first step of defining embryos as undetermined potentiality. Boundaries

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became part of constituting what was articulated as boundless potential. However,placing the ugly embryo in the hESC laboratory did not imply that the donatedembryo was disposed of fully. Some couples emphasis on disconnections betweenthemselves and the donated embryo as well as other couples concerns about wheresomething of themwent expressed experiences of traces of a connectedness in timeand in social relations envisioned through a biological tie. I suggest that a clue to un-derstanding the couples urgency to claim disconnections is to be found in the wayembryo donations actualized a particular notion of potentiality (the blank figure),a particular Euro-American way of envisioning kinship (being connected througha biological tie in time and in relations), and two incompatible moral framingsof the embryo (biographical life and biological life), which, in a Danish context,placed the embryo in relation to two different collectivesthe collective of kinand the unspecified collective of society. For the couples, by experiencing donationas therapeutic hope and not therapeutic fear, the invocation of boundaries becameessential.

Having laid bare the articulations of potentiality and the implied boundarywork that contributed to successfully redirecting embryos from IVF to hESCresearch, it may well be asked what happened to these embryos in the laboratory.Did articulations of potentiality pave the way for a shift in the organization andsuccession of the elements of life? In the Danish case, as has been the case instem cell laboratories around the world, ugly embryos answered back by actingdifferently than was hoped. They did not transmute into successful stem cell lines.The Danish stem cell researchers were frustrated with the poor quality of theseembryos and were eager to receive fresh embryos of high quality. In an attemptto meet the researchers demands, the clinicians in the fertility clinic tried a newdefinition of what made up a spare embryo to be donated to hESC research. Morethan can be used, not other than can be used, was introduced as a defining featureof embryos suggested for donation to hESC research. In practice this meant thatcouples who had a great number of good-looking fresh embryos were asked ifthey would donate one or several to hESC research. (For a further analysis of theongoing fact making of the spare embryo in the clinic, see Svendsen and Koch2008.) However, such articulations of potentiality based on quantity did not comeeasily to the clinicians. Asking IVF couples who had not yet reached the goal ofa baby to donate beautiful embryos to hESC research conflicted with clinicalcommitments to put the interests of the patient before those of research. Duringmy fieldwork, I saw only one IVF couple asked to donate beautiful embryos tohESC research. So while the material processes in the laboratory pointed to the

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good-looking embryos as a great potentiality,moral considerationsmade it almostimpossible for the clinicians to practice such articulations. Consequently, only veryfew good-looking embryos were placed on the research trail and articulated aspotential in relation to hESC research. So while in a Euro-American setting itis a commonsense understanding that biological material processes provide thegrounds on which social actions take place (cf. Strathern 1992b), my case revealsthat social actionsthat is, articulations and their moral horizonsinteract withmaterial processes and shape what comes to appear as potential.

The boundless potentiality articulated in the present case may reflect a biopol-itics occupied with the optimization of health through the creation and circulationof biological objects. Tissue donation, the current trade in organs and reproductivesubstances, and the creation of transgenic animals, combining human and animalDNA, are practices that all point to the powerful vision of acquiring both healthand monetary value through eliminating bodily, geographical, infrastructural, andspecies-related boundaries. With the embryo case studied here, I have excavatedand deployed the categories of waste, blankness, and potentiality in envisioningboundlessness and constituting biological objects and their circulation, and thesecategories may have resonance outside the field of stem cell research. Notably, theidea of waste as an act of placing, an act of moving along, with a capacity for trans-formation, is present in discussions on environmental issues and climate change.In such discussions waste is often feared as an unwanted potential that may return,just as recycling initiatives express an idea of transforming waste into blank slates tobe repotentialized as objects, creating both boundless environmental sustainabilityand monetary value.What stands out in the embryo case is the way waste facilitatesa notion of the blank while simultaneously traces appear and create ambiguity. Inthis light, the specific practices through which the categories of waste, blankness,and potentiality become part of envisioning boundlessness and constituting andcirculating objects raises larger anthropological questions about what is involvedin making something appear valueless and absent, how the absent, which once waspresent, may create traces in social relations and object making practices, and howsocial relations and exchange orders are practiced through holding things in a stateof absence yet managing their possible presence.

ABSTRACTLife science research is continuously engaged in exploring, measuring, or limitingpotentials for life. The concept of potentiality pervades practices surrounding cells,bodies, and technologies. Based on an ethnographic study of how couples in fertility

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treatment become donors of embryos to human embryonic stem cell (hESC) research inDenmark, I explore ways of measuring and talking about the potentiality of embryosin the fertility clinic and in interviews with donors in their homes. In the fertilityclinic, the embryo suggested for donation to hESC research is defined as waste thatcannot be used and therefore is suggested to be put in the bin. The bin, thereby,becomes a dominant conceptual framework for claiming the embryos nonpotentiality asa biographical life and for making the embryo for donation emerge as a blank figure,the essentially undefined and undetermined element that has potential to take on anyidentity but, as yet, has no specific determination. When further exploring how the invitro fertilization (IVF) couples relate to the potentiality of donated embryos, I arguethat the embryo suggested for donation is not experienced as completely blank: tracesremain of the embryos former identity as a possible biographical life related to itsparents. To make the embryo blankerindeed, safely blankit becomes imperativefor the couples to set up boundaries to eliminate the possibility of an unwanted return.Drawing on rubbish theory, kinship theory, and Michel Serress concept of the blankfigure, I draw attention to the boundary work as well as the trace effects expressed inarticulations of potentiality. [potentiality, embryo, stem cell research, donation,kinship, Scandinavia]

NOTESAcknowledgments. I thank Karen-Sue Taussig for providing the impetus to reflect on poten-

tiality. I thank both her and Klaus Hoeyer for stimulating discussions of potentiality as a theme inanthropology. An earlier version of this article was presented in a panel on potentiality and humannessat the annual meeting of the American Anthropological Association in San Francisco, in November2008. I wish to thank the participants in the panel for helpful input. I am indebted to Lene Koch,Henriette Langstrup, and Klaus Hoeyer for their comments on earlier versions of this article. Ialso thank the three anonymous reviewers and the editors of Cultural Anthropology for their valuablecomments.

1. At the time of my fieldwork, state-financed IVF treatment was accessible only to heterosexualcouples; consequently, I did not encounter any single women or lesbian couples in the clinic.With the passing of a new fertility act in 2006, subsidization of IVF for all female citizens wasintroduced.

2. When consenting to donate, couples should also consent to theirmedical records being accessibleto hospital staff, thus indicating the need to make donors traceable. The information sheetsmade explicitly clear that there would be full anonymity between donors and receivers. Thesheets also stated that the couple could withdraw their consent within five days. When donatedthe laboratory was entitled to dispose of embryos within the framework of the law, and afterthe fifth day, if taking the stem cell line, the whole embryo ceased to exist.

3. In a later publication, Kevin Heatherington (2004) explicitly discusses the issue of disposal inrelation to anthropological theory. He states that the anthropological literature on practices ofgetting rid of things and meanings (i.e., gift giving, potlatch, burial rites, sacrifice, pollution)has demonstrated disposal as integral to the performance of social relations and the organizationof society (Heatherington 2004:159). He claims that what is not addressed by this literature isthe way in which dirt can flow andmove between states of absence and presence.Whereas MaryDouglas tended to assume that, through being categorized as matter out of place, dirt couldgo away, Heatherington argues that social scientists need to address how something movesbetween the categories of absence and presence and how actors manage and are managed by the

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absent. Given his interest in consumption, Heatherington concludes that disposal should notbe seen as something that comes after consumption but as an activity that is involved in makingconsumption a socially meaningful activity.

4. The distinction between biographical and biological life finds resonance in other empiricalfields. Stefan Timmermans study of resuscitation technology in the United States revealshow the biographical life of the person suffering from sudden death is suspended throughresuscitative attempts. Two strangers, rescuer and victim, touch mouth to mouth without anysexual associations. Medics cut through expensive clothes and feel for a pulse without askingfor consent. From being a person entrenched in a network of friends and family, the person incardiac arrest is redefined as a generic patient (Timmermans 1996), a biological life stripped ofsocial relations and identities.

5. Klaus Hoeyer also discusses this theme in a study of tissue donation in Sweden (Hoeyer2005:5657).

Editors Note: Cultural Anthropology has published a number of essays on the life sciences. See, forexample, Eva Haywards Fingeryeyes: Impressions of Cup Corals (2010), Heather PaxsonsPost-Pasteurian Cultures: The Microbiopolitics of Raw-Milk Cheese in the United States(2008), and Deepa Reddys Good Gifts for the Common Good: Blood and Bioethics in theMarket of Genetic Research (2007).

Cultural Anthropology has also published a number of essays on reproduction and reproductivetechnologies, including Elizabeth L. Krauses Empty Cradles and the Quiet Revolution: De-mographic Discourse and Cultural Struggles of Gender, Race, and Class in Italy (2001), JudithFarquhars Technologies of Everyday Life: The Economy of Impotence in Reform China(1999), and Corrine P. Haydens Gender, Genetics, and Generation: Reformulating Biologyin Lesbian Kinship (1995).

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